Public entomologists struggle with an epidemic of delusional parasitosis

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Dr Gale Ridge is a public entomologist at the Connecticut Agricultural Experiment Station, where an average of 23 people a day call, write or visit; an increasing proportion of them aren't inquiring about actual insects, they're suffering from delusional parasitosis, and they're desperate and even suicidal.

Nancy Hinkle, a colleague of Gale's, professor of veterinary entomology at the University of Georgia in Athens, estimates that she spends "a couple of hours every day" dealing with "the invisible bugs."

The entomologists' jobs are confounded by the possibility that the weird "bugs" aren't delusional. The world of arthropods is sufficiently weird that it's hard to rule out a rare or unknown bug causing mischief; not to mention the complications of industrial de-humidifiers that make "the room buzz with static electricity" that feels like bugs crawling on your skin. Then there are the well-meaning MDs who mistake their patients' scratch-marks for bug bites.

The entomologists have learned to stage interventions with their "clients'" families, bringing them together to explain the realities of insect behavior, to bring them to the gradual understanding that their problems are real, but the bugs are not.

Not addressed in the story, but very interesting: why the sharp increase in delusional parasitosis? Is it a reduction in the public health services that would have intercepted these people before they got to the entomologists? Is it scare-stories about bedbugs and lyme disease? Aggressive hand-sanitizer ads with their subtext of lurking, dangerous dirtiness?

It sometimes takes her months to win clients’ trust. At first, they argue, citing websites like stopskinmites.com as proof of their infestation, and Ridge needs to counteract the misinformation they have found there. “This is a piece of lint,” Ridge told me, pointing to a photo that the website suggested was a mite. She sees these sites as a ruse to get people to buy pseudo-medical products, and as a danger to her clients.

“Often in the early stages there’s lot of pushback,” she said, “but they keep coming back, which means they have — deep down — doubt. I keep reassuring them: I’m not judging them.”

She can be maternal, careful to validate what her clients are feeling, becoming stern when she needs to. She sometimes organizes family interventions in a conference room at the Experiment Station, with as many as 11 relatives around a table, trying to address the problem together. She likes “the satisfaction of seeing someone healed.”

“I can help those cases when they have not been invested more than six months, and when they have support from loved ones or friends,” she said. “Those that have become isolated, and have developed habits of self-treatment are very hard to pull back from the brink.”

They don’t often open up at first. As the relationship develops, though, they begin to confide in Ridge. And there is usually something to confide, some emotional upheaval in the background: a divorce, a stressful move, the loss of a loved one. She saw an uptick in these cases right after the 2008 recession. After the physician-researcher’s death, she found out that his family had left him. The separation had happened right around the time of his first bites.

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